Drop in heart disease deaths linked to ACA's Medicaid expansion, study says

Authored by upi.com and submitted by mvea
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State expansions in Medicaid appear to be linked to a drop in the number of deaths from heart disease, according to a new study. File photo by piotr_pabijan/Shutterstock

New research supports the notion that Obamacare has improved the health of Americans: State expansions in Medicaid appear to have cut the number of deaths from heart disease.

Counties in states with expanded Medicaid experienced an average of four fewer deaths from heart disease per 100,000 people than states that didn't accept the expansion under the Affordable Care Act.

In real terms, that's about 2,000 fewer deaths a year among middle-aged adults.

"We believe these findings will be helpful for policymakers and health policy researchers in trying to tease out the impact of this most recent round of expansion," said researcher Dr. Sameed Khatana, a cardiovascular medicine fellow at the University of Pennsylvania.

"We can't necessarily say from our study that giving a person health insurance through Medicaid will save their life," Khatana said in a university news release. The research only found an association rather than a cause-and-effect link. "However, our study does show that at a population level, expanding Medicaid was associated with a reduction in deaths from cardiovascular disease. This was especially prominent in areas with a higher number of residents living in poverty and those areas that had greater increases in insurance coverage," he said.

For the study, Khatana and his colleagues used data from the U.S. Centers for Disease Control and Prevention to look at county rates of heart disease deaths from 2010 to 2016 in 29 states with expanded Medicaid and 19 states without it.

They found that deaths from heart disease remained stable in states with expanded Medicaid. In states without added Medicaid, however, heart disease deaths climbed from 176 per 100,000 to nearly 181.

In addition, the largest increases in heart disease deaths were in counties with the smallest increases in insurance between 2010 and 2016.

The report was published online June 5 in the journal JAMA Cardiology.

The American Heart Association offers more information on types of heart disease.

Copyright 2019 HealthDay. All rights reserved.

HowdyGangstas on June 11st, 2019 at 14:49 UTC »

"We can't necessarily say from our study that giving a person health insurance through Medicaid will save their life," Khatana said in a university news release. The research only found an association rather than a cause-and-effect link.

They found that deaths from heart disease remained stable in states with expanded Medicaid. In states without added Medicaid, however, heart disease deaths climbed from 176 per 100,000 to nearly 181.

The article itself really only describes a very minor statistical change that they admit is nothing more than a correlation (requiring further study)

AustinC1296 on June 11st, 2019 at 14:02 UTC »

Does anyone have a link to the actual study? I didn’t see the link on the article. Thanks.

mvea on June 11st, 2019 at 12:34 UTC »

The title of the post is a copy and paste from the title and first paragraph of the linked academic press release here:

Drop in heart disease deaths linked to ACA's Medicaid expansion, study says

New research supports the notion that Obamacare has improved the health of Americans: State expansions in Medicaid appear to have cut the number of deaths from heart disease.

Journal Reference:

Khatana SAM, Bhatla A, Nathan AS, et al.

Association of Medicaid Expansion With Cardiovascular Mortality.

JAMA Cardiology. Published online June 05, 2019.

Link: https://jamanetwork.com/journals/jamacardiology/fullarticle/2734704

doi:10.1001/jamacardio.2019.1651

Key Points

Question Has the expansion of Medicaid eligibility under the Affordable Care Act been associated with any differences in cardiovascular mortality rates?

Findings In this difference-in-differences analysis, states that expanded eligibility for Medicaid had a significantly smaller increase in rates of cardiovascular mortality for middle-aged adults after expansion than states that did not expand Medicaid.

Meaning Medicaid expansion was associated with lower cardiovascular mortality and may be an important consideration for states debating expansion of Medicaid eligibility.

Abstract

Importance Medicaid expansion under the Patient Protection and Affordable Care Act led to one of the largest gains in health insurance coverage for nonelderly adults in the United States. However, its association with cardiovascular mortality is unclear.

Objective To investigate the association of Medicaid expansion with cardiovascular mortality rates in middle-aged adults.

Design, Setting, and Participants This study used a longitudinal, observational design, using a difference-in-differences approach with county-level data from counties in 48 states (excluding Massachusetts and Wisconsin) and Washington, DC, from 2010 to 2016. Adults aged 45 to 64 years were included. Data were analyzed from November 2018 to January 2019.

Exposures Residence in a Medicaid expansion state.

Main Outcomes and Measures Difference-in-differences of annual, age-adjusted cardiovascular mortality rates from before Medicaid expansion to after expansion.

Results As of 2016, 29 states and Washington, DC, had expanded Medicaid eligibility, while 19 states had not. Compared with counties in Medicaid nonexpansion states, counties in expansion states had a greater decrease in the percentage of uninsured residents at all income levels (mean [SD], 7.3% [3.2%] vs 5.6% [2.7%]; P < .001) and in low income strata (19.8% [5.5%] vs 13.5% [3.9%]; P < .001) between 2010 and 2016. Counties in expansion states had a smaller change in cardiovascular mortality rates after expansion (146.5 [95% CI, 132.4-160.7] to 146.4 [95% CI, 131.9-161.0] deaths per 100 000 residents per year) than counties in nonexpansion states did (176.3 [95% CI, 154.2-198.5] to 180.9 [95% CI, 158.0-203.8] deaths per 100 000 residents per year). After accounting for demographic, clinical, and economic differences, counties in expansion states had 4.3 (95% CI, 1.8-6.9) fewer deaths per 100 000 residents per year from cardiovascular causes after Medicaid expansion than if they had followed the same trends as counties in nonexpansion states.

Conclusions and Relevance Counties in states that expanded Medicaid had a significantly smaller increase in cardiovascular mortality rates among middle-aged adults after expansion compared with counties in states that did not expand Medicaid. These findings suggest that recent Medicaid expansion was associated with lower cardiovascular mortality in middle-aged adults and may be of consideration as further expansion of Medicaid is debated.